ArticlePrehospital emergency care
Physiologic field triage criteria for identifying seriously injured older adults.
Article in Prehospital emergency care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
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Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Under-triage of older trauma patients in prehospital care: a systematic review.European geriatric medicine · 2021Pooled it
- Evaluation of elderly specific pre-hospital trauma triage criteria: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Pooled it
- Influence of Antithrombotics on Severely Injured Patients Over 50 With Blunt Abdominal Trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Criteria for the qualification of geriatric patients to the trauma center.World journal of emergency surgery : WJES · 2026Article
- Comparative statistical performance of prehospital scoring systems with and without incorporating age for predicting multiple trauma outcomes: an observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Observational
- Article
- The impacts of ageing-related changes on prehospital trauma care for older adults: challenges and future directions.Frontiers in medicine · 2025Review
- Optimising prehospital trauma triage for older adults: challenges, limitations, and future directions.Frontiers in medicine · 2025Review
- Massive transfusion protocol reactivation as a novel marker of physician team under-triage after injury.Transfusion · 2024Article
- Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Research priorities for prehospital care of older patients with injuries: scoping review.Age and ageing · 2022Article
- Individual risk factors predictive of major trauma in pre-hospital injured older patients: a systematic review.British paramedic journal · 2022Review
- Revising Vital Signs Criteria for Accurate Triage of Older Adults in the Emergency Department.International journal of general medicine · 2022Article
- Comparative analysis of MGAP, GAP, and RISC2 as predictors of patient outcome and emergency interventional need in emergency room treatment of the injured.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Towards improving prehospital triage for older trauma patients.Zeitschrift fur Gerontologie und Geriatrie · 2021Review
- Do elderly trauma patients receive the required treatment? Epidemiology and outcome of geriatric trauma patients treated at different levels of trauma care.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2020Article
- The influence of sociodemographic factors on trauma center transport for severely injured older adults.Health services research · 2020Article
- Crash Telemetry-Based Injury Severity Prediction is Equivalent to or Out-Performs Field Protocols in Triage of Planar Vehicle Collisions.Prehospital and disaster medicine · 2019Article
- Reliability and performance of the Swiss Emergency Triage Scale used by paramedics.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2019Article
- Comorbidities, anticoagulants, and geriatric-specific physiology for the field triage of injured older adults.The journal of trauma and acute care surgery · 2019Article
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Authors and funding
11 authors.
Funding
Abstract
objectiveTo evaluate the ability of out-of-hospital physiologic measures to predict serious injury for field triage purposes among older adults and potentially reduce the undertriage of seriously injured elders to non-trauma hospitals.
methodsThis was a retrospective cohort study involving injured adults 55 years and older transported by 94 emergency medical services (EMS) agencies to 122 hospitals (trauma and non-trauma) in 7 regions of the western United States from January 1, 2006 to December 31, 2008. We evaluated initial out-of-hospital Glasgow Coma Scale (GCS) score, systolic blood pressure (SBP), respiratory rate, heart rate, shock index (SBP ÷ heart rate), out-of-hospital procedures, mechanism of injury, and patient demographics. The primary outcome was "serious injury," defined as Injury Severity Score (ISS) ≥ 16, as a measure of trauma center need. We used multivariable regression models, fractional polynomials and binary recursive partitioning to evaluate appropriate physiologic cut-points and the value of different physiologic triage criteria.
resultsA total of 44,890 injured older adults were evaluated and transported by EMS, of whom 2,328 (5.2%) had ISS ≥ 16. Nonlinear associations existed between all physiologic measures and ISS ≥ 16 (unadjusted and adjusted p ≤ 0.001 for all,), except for heart rate (adjusted p = 0.48). Revised physiologic triage criteria included GCS score ≤ 14; respiratory rate < 10 or > 24 breaths per minute or assisted ventilation; and SBP < 110 or > 200 mmHg. Compared to current triage practices, the revised criteria would increase triage sensitivity from 78.6 to 86.3% (difference 7.7%, 95% CI 6.1-9.6%), reduce specificity from 75.5 to 60.7% (difference 14.8%, 95% CI 14.3-15.3%), and increase the proportion of patients without serious injuries transported to major trauma centers by 60%.
conclusionsExisting out-of-hospital physiologic triage criteria could be revised to better identify seriously injured older adults at the expense of increasing overtriage to major trauma centers.
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